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Andy Grove takes on drug development

Intel's former CEO has a bone to pick with drug development, but are his …

Don't you just hate analogies? Well, perhaps not, but they have their time and place and, as we all know from arguing on the internet, that time and that place is far less often than one thinks. No one likes car analogies when it comes to talking about computers, and computer analogies don't really work when it comes to talking about cars. And despite what Andy Grove, former Intel CEO thinks, computer analogies don't work when it comes to drug development.

Grove, a former prostate cancer patient, has been diagnosed with Parkinson's disease, and he recently vented to Newsweek about how the pharmaceutical industry is doing a bad job compared to chip manufacturers. On Sunday, he will be going to the annual meeting of the Society of Neuroscience to give a speech saying much the same thing.

Frankly, it's a little hard to even know where to start. Being diagnosed with a condition like Parkinson's cannot be an easy thing and, although we know more about the processes involved in the disease each year, knowing and doing are separate things. Grove seems to be angry that the speed of drug development doesn't match that of Intel's or AMD's new chip roadmaps.

First off, living organisms are orders of magnitude more complex than microprocessors. As Derek Lowe points out, a CPU schematic might look awe-inspiring, but when you compare it to the biochemical pathways that are active in just a single cell, it pales in comparison. Chips aren't constantly evolving ways to exploit flaws in process technology either, unlike cancer cells and infectious agents. Biology isn't binary, and semiconductors don't have downstream signaling cascades.

There are hundreds of reasons why drugs don't make it to market. A computer that crashes occasionally because it overheats might be irritating. A drug that causes liver failure or only works by being injected into the brain is a little more serious. There's a reason it takes about 13 years to take a new molecule to market; there's an awful lot of testing required along the way, and a lot of regulatory oversight. Processors don't need to be tested to see whether or not they cause birth defects or cancer, and by their nature those things take time.

He's also not happy that new drug candidates are discarded or abandoned if they don't outperform placebos, suggesting that the statistics might hide small populations that do respond to the drugs. But it's foolish to think that the pharmaceutical companies don't look for precisely that—by the time experimental drugs are given to human subjects, the companies have already sunk tens of millions of dollars into them. Everything from the off-label use scandals to the successful repurposing of minoxidil and bupropion shows that drug companies do everything they can to find some way of using every compound they develop this far. In the meantime, however, the FDA and other regulatory bodies around the world aren't in the habit of approving drugs that don't work. Grove has a case when he suggests that pharmacogenomics might improve this process, and it's clearly a rapidly growing field, but it's also both costly and time-consuming.

Finally, Grove sets his sights on peer review and academia. We've discussed some of the issues regarding peer review here in the past, but to claim that academics aren't interested in curing diseases borders on the offensive. I'll just refer back to my first point; silicon chips cannot compare to biological systems in terms of complexity. Moving to ever smaller dies might seem tricky, but a CPU isn't constantly making itself new transistors.

If he feels as strongly as he evidently does on the topic, my only suggestion is to take some of his Intel billions and set up a research institute of his own. Of course, if that didn't produce new drugs at the same rate Intel churns out new chips, someone might have a little egg on their face.

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